Depression is a widespread mental health problem and is estimated to affect three hundred and fifty million people worldwide. Depression is associated with negative psychosocial outcomes, reduced productivity and decreased quality of life and well-being, and is predicted to be the world’s second leading cause of disease burden by the year 2020. In addition, health care facilities cost officials billions of dollars annually to regulate this disease. In view of its effect on public health, new methods are essential to postpone and avoid the progression of depression. The depression in society among the elderly has been a major problem in society today. The disease occurs in multiple ways, either recurrent or recurring, i.e. When an adult has depression, it greatly affects both emotional and physical capacity. Hypertension, for example, can be complicated by depression in adults with other underlying conditions. It is possible that an elderly person with little to no help will suffer from this disorder. Feeling ignored by members of close family and friends raises one’s sense of isolation and hopelessness. They, in fact, are at a higher risk of becoming depressed. This paper discusses depression as an ageing disorder, its causes, symptoms, and medication.
Background
Depression is a psychiatric illness that distresses the victim’s mind, body and soul. The disorder greatly decreases the quality of life, efficiency and personal joy of the individual. In their old stages, most individuals become depressed, this is not an ageing phase, but it is a common disorder among older people. The Centre for Disease Control and Prevention (CDC) has established that depression affects 1% – 5% of the elderly population. Of this, 13.5 percent needed home-based care, while for close supervision and treatment, 11.5 percent required hospitalization. The elderly represents a large part of society. Family members, community health workers and the government are the main players impacted by their illness (Giguere et al., 2018). The treatment and general well-being of the old in society is the responsibility of these individuals. In the event that they become ill, both the family and the general public are left with a void. Such people would not be able to undertake normal living tasks. Consequently, they are entirely dependent on the working population for their needs. In addition, because they require close supervision and treatment, they cause a burden on public services.
Some of the documented symptoms of depression among the elderly include
Causes
Various factors constitute the causes of depression among the elderly. The events that an adult person undergoes in life has been thought by various scholars to be a predisposing factor for depression. Other factors such as the loss of loved ones such as a son, or daughter, husband or wife or a close relative can be traumatizing and result in depression. Moreover, the lack of enough social support has been documented to be a major cause of depression. Older people require enough care and attention from their loved ones. However, the lack of this kind of social support and attention may cause depression and other traumatic thoughts. Besides some adults live with various disabilities, which can precipitate feelings of depression. Impairment can make the elderly always feel that they are a burden to other people. such feelings make them have certain feelings that make them reserved and not willing to talk to others as they mostly resolve to stay lonely.
There is also a growing level of evidence suggesting that an individual’s risk of depression is increased by the natural changes in the body that come along with aging. As the body ages, the concentration of folate in the blood and nervous system reduces significantly. This may contribute to depression, dementia, and mental impairment. Besides, other evidence suggests that Alzheimer’s disease has a link to the late-life depression in adults. Therefore, while depression can be such a drastic disorder among the elderly, its causes are varied.
Depression can also be caused by gender. Various studies have concluded that depression is more prevalent in women than in men. However, the exact reason for that remains unknown yet. Nevertheless, it is thought that estrogen hormone exerts a significant level of stress on the stress hormone making women more prone to stress at an older age, and hence depression than men. Moreover, women experience throughout their lives, common types of violence such as domestic violence, rape, and cortisol. All these are factors which can gang up and cause a lot of depression in old age. While it is true that women have the highest likelihood to experience more stress than males, studies reveal that the expression of depression among these two genders is very different. This is because men do not easily reveal their emotions or say when stressed. They always choose to die with their pain. However, their lifestyle can reveal certain characteristics of depression. For instance, they ca become violent or indulge into drinking and drug abuse. Women on the other hand, will just express their feelings either by crying or by seeking help. The bottom line is that, the causes of depression are varied.
Symptoms
It is possible to recognize depression among the adults and the elderly by monitoring various symptoms and signs. The following signs and symptoms will signify that an elderly person is depressed. They include feeling sad and being in despair, loss of self-worth, suicidal thoughts, alcohol use and drugs, loss of appetite and weight, lack of energy and motivation. Other signs include lack of or too much sleep, pain and body aches that cannot be explained, neglecting personal care, and memory loss. These symptoms will tell that a person is depressed and needs help.
Treatment
Regardless of the type of depression, the patient can be treated. One of the steps in seeking treatment for depression is seeking medical help by visiting a doctor for examination. The doctor will then rule out depending on his examination whether it is depression caused by other factors or some medications. By having an examination and lab tests done, these possibilities can be ruled out. Psychological evaluation is also done by the doctor. It is after this that various treatment choices can be suggested to the patient.
The common treatment choices for depressed adults include psychotherapy and medication. Psychotherapy involves talking to the patient to help with depression. Psychotherapy can have sessions planned for the patient taking 10-20 weeks. Other sessions can take longer than that depending with the needs of the patient. Cognitive Behavioral Therapy (CBT) is the common type of talk therapy for depression. The emphasis of CBT is helping the patient leave his negative thinking and focus on positive thinking. The patient is helped to focus on helpful and positive thoughts alone, making them feel less depressed. Other forms of therapy like interpersonal therapy can be used to help the person work through the difficult relationships that cause depression. Other forms such as problem-solving have been found to be very important and helpful to depression patients.
Medications
| Medicine | Side |
| Selective Serotonin reuptake inhibitors (SSRI) such as citalopram and fluoxetine. | Gastro intestinal bleeding, nausea, excessive sweating, and diarrhea. |
| Remeron | Lower doses can cause sedation |
| Aventyl | Cardiovascular side effects |
| Effexor | Increase blood pressure |
| Wellbutrin | Seizures |
Recreational Therapy (RT)
Depression has become a significant factor in addressing RT in the current world. Poor rehabilitation might lead to prolonged periods of depression among patients.
RT theories such as Health Protection/ Health Promotion (HP/HP) Model (Austin, 1998) and Flourishing through Leisure Model (Anderson & Heyne, 2012) support the influence of self-efficacy and self-determination, both of which are important ingredients for motivation. RT professionals influence self-efficacy by facilitating the sources of self-efficacy such as mastery experience, verbal persuasion, and vicarious experience (Bandura, 1994).